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Home My WebLink About30341946 - Permit (2)Project Address: 1610 W EdinLer Ave Assessor'sParcel: 408-261-12 Lot: POR 1, POR 4/PC Bldg: Address Range: Tract REcORD SURVEY t'listoric: No Suite Range: Zoning: C5 City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CAg27o2 Plumbing Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 Permit #: 3034{946 Pin #: 945o$.i Owner: Address Phone: Tenant Name: Contractor: Address: Santa Ana DJ Properties, LLC 16,10 W EDINGER AVE C Santa Ana, CA 927044339 (714't 432-7337 Yoham Kim Dental Corporation Owner-Builder 01 1 16002 01 1 16002 01 1 '16002 01 1 16002 0'1 1 16002 01116002 01116002 01 1 16002 51602 51602 51602 51602 5'1602 5160C 5'1 602 577 7t Fee Type Amount Sink 13.20 Cap Fixtures 7.22 Wtr Hlr (Comm up to 50 23.12 Denlal Unit 33.57 Field Verification 166.53 General Plan Updale 22 95 lssuance 57.20 lMicrofilm Records 3.91 Qty 2.OO 4.00 1.00 4.00 1.00 1.00 1.00 1.00 Fee $26.40 $28.88 $23.12 $134.28 $166.s3 $22.95 $57.20 $3.91 Phone State Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance Carrier:\ Poticy #: Expires: Botch+:t4462 - z/fq /2O2O ID: s$oroleslg0ffice: CTYH TPonsi! 1(t2 1 ol IAccti: Ref+: 30341946 R(pti:028979{9 - 2tt9 /2020 12:54 Pfl fronsoct ion Totol $463.?7 Sonto Ans DJ Properties' LL( Building Use: Job Type: Nature of Work Planning Conditions: Commercial Miscellaneous Fixtures B VB cPc 2019 Per C of O corIection-Dental chairs, sinks, water healer and cap fixtures. Auth on file. Occupancyi Constr Type: Code: Notes Graham, Jeffery Date: 0211312020 Misc. Receipt: Misc. Receipt: Misc. Receipt: Total V:::Zuniga, Allissa J. de Soto o2t1912020 Account# 01 1 16002 5'1600 01 1 16002 51602 011'16002 57770 Fee Total Paid to Date: Balance Due: Every pernit issuad sha become invalid unless tho wo* on tho site authoized by such pemil is commenced within360 days after its issuanco, o. il tho wotk authoized on the sita by such pemit is suspended ot abandoned lor a petiod of360 days after the time the wo* is comfienced. lnspector MID#: 2020-157782 $22.95 $436.41 $3.91 $463.27 $0.00 $463.27 Unil: A Block: NA Planning Approval By: Plan Checked Byl Permit lssued By: Subject to Field: Building Permit #l PLUMBING.INSPECTOR RECORD APPROVALS DATE otvNtR lru l t,DFiR Dlil,( ARATIoN I hcrchy rlltr xnlur pcnrlrt ofFlury rhrl I inrcrcnrnl ltn rhc Co rr.tr\'l-icctr l,rrv li)r rh. rnll,)wira rcnvm {scc7o.ll5 llu\irE$ rxl l\ori\\nnr Codr) ^tr, Cirr_ or Cooniy (hich r.qotrc\ r pcnnir r, condrucr. rlrcr. irtr|(nc. dc mlinr or rcPrt M' nr rlrc f)risn \ ol rhc Cotrrr.ktr \ Li.c scd ttrs lchilr$ q. C nnn.nci'rt *irh ScctFD 7(xx) oi Dilntun I of rN Inr\inc$ rtrd rn|]li$nr lar apcnnir \rhjc.r\ rhc .tTllcnnr lo a.ivilIrtrrht or or ntrc rhrn rlrc hundrcd d.lld\ lSJu)r' Lr\.wncrolrlrcprrp.ny.oinrvc'nfkitt\\rirhtrn8csn\rhcirv,tuconftnsri(.*illlorlEworklrlrlrinrcNrui\mr rlIfn,rny shr huilds or i'np' {r$ rhcfrnr. 8 *hod,t\u.hsodhnnsrllorhcr{lforr[nu3hhirorh.r.sncnrPl,r).us. p(,ridcd rhrr nr.h i'npovcunh m mr i'n.ftLi or ollcrd n, elc Ir. hos.\ c'. rh. huildn[ or i Pn*r.rd is hU \ irhi'r ' 'n. !r'ir oi!1,,pLrim. ihcO$ncr Auiklcr will hrrc rtl tnrdcnofp(,!i'r! rlrr lEor \h. iil nor huiu or i'Vrovc rhc lmllry ri, rh. ,)urliM of ---r ;( o*mr or rhc roncny. !n .\clu!k l, conrEd 'n8 enh iccn$d conrftb6 lo onslrud llE tmj{rr (56. 7(l'4. Burimss -ond htâ‚¬ssir Codc. Th. Conrd.rors Lrcne Llw docs rul,Ilnly rn an oenn of|lroPcn, *ho buildeor impm$. rhcrc... rnd eho ontds for such prolck wth , ContBcro(, liccnsd lununl lo rhc Contdols Liccns Liw) z-o I)IILAIATI!)J I h.rcb, afinn undcr Fnrlly of lsju.y o* or lh. lollowirB dRlomttunr: Irhn L,rlc. tur rlr Nrbnnrnrc olrhc Nrrk tu sh(h lhc |urril i\ i\{rctl -l h!!c and Bill hlinraa. wortc^ .omrcns.lk{ inr!6tuc- &1 Elutcd by Scl iofl 37m oI ihc L,bor Codc for llt psfo@@ of rhc $dk f.r *hi.h thh p.mn is h cd. My {orls .dn ..satbn iNur.m. .aFicr dd Flicy nlmhcr m: Pnl''t Numtfl -rrri'r' l.rditt ih r nr lhc NrlnnMncc ofrhc work lnl shi.h rhi\ p.rnrir n n cd.I \hrllnor.nllnoynnyl.^on ir drynr.trncr $ Nn,trc( * snLi n,rlr so*c6'compcn\alion h*solC,lif{ntri!. rndngtrcrhir iiIsh,uld lN.nr \uhrcl rorhc sorkcri conD.tr\arion f)vi\inn.orSe.rirn l?mntrh. khn C(rlc,I \h.ll. l,onh!iih conrrly *irh rhos fmrisions.I WARNIN(; F ilur. ro s.urs wo*f(.o rr.r\nli.n $\cm!c i\ u.h*Iul. xiJ \hrll su[j.ct nrr cnrPl,)y.r b dnnirrl Ftrrhi.\ md .ivil llicsxpt(,omhu rcd rho!\md dollns (JlrXl.(XXD. in i.htion n,rhc ro{ ofcontFtrsarbn. drroScs as nmr cd nn]hc s(ri(,n 1076olrlr tat rC,xb. irn.n{ Md -z-O I hrr.hylrftnrtrnd$rn.llyoinc,juryrhrr I nm li.c td undrr tnovi\nnr.iChrlrrr9l.onnrtn.iD8wilhSccli,n Totr)).rDivnim I of tu Bx\i.c* d PrulcisiorsCodc. oul my liccis. i\ i'r tullturc d cilccr CONSjkUCTION I FNNIN(: A(;ENCY I hcrcbynl6nnuM.r Fn,lryoipcriu.yrhur rhcrc isD.on{tu.rion k ms!!ocyi rh.N Unn r.colrhc work tnqhi.hrhi\ Pcnni h i$uql (Scc.10s7. Civ C ) tr.trJ..\ N.urtr: - lxnJcr's Addrc!\ - AI]I,ICANLDII;IASAIIQN I Easy afilnn tndcr Fnalry uttf,rjury onc .f rl'( tnlkNirs dccl,'rrnN Dr.nniriotr Pcnnirs Asbc\ro\ Norific iotr ltdcralRcAuhrions (TirlcJ0. Prd6) -Rcqutcd lrI.r of Mrili..raon I ccnifyrhrr rtc fcdcril rslltrri.ns ngarding !s6c(osrcaFvnl{d norlpFlicnblc t,lhh l)lojccl ihlr I hlvc rcad rnii 0pdiilion lnd slatc rtnl rhc atbvc inaoirmtiotr is cotr(t I lge k, conFly wirh all Cirv anrl C.un'v irrRs s.d Srarc Llws EirinS ro buildinS .oNlrudion. o,n hcrcb, surhori4 tclmsnhlivcs of lhis Cny ,rd Counl, to cnrq uFln llE ah)lc mnfi,rd ,,ropcny ior irspc.rin, purFxdr. Aprlirhnl or AEcnl Siamlum Kint *,,{rqh Waste & Vent Water-Under lloor Buildino Sewer Area/Storm Drain I nterceptor/ Clarilier TOP OUT Water Pipinq Gas Pipinq Roof Drain Tub/Shower Test Rouqh Water Heater POOL/SPA P-trap/Drain Line tvlain Drain/Pool Piping Fill Line/Back Flow Pool Heater/Gas Line Miscellaneous Gas Service Water Service Lawn Sprinkler Sanitary Sewer/Cap Back Flow Device Rouqh Plumbinq 7z/zo rtE- /// Final Gas Test Meter Release FINAL 9,/2,/a (-L' s o ta> AD Notes, Remarks, Etc.7 COMMENTS UNDER GROUND Gas-Underfloor Waste & Vent ID/SIG. Planning & Building Agency Building Safety Division 20 Civic Center Plaza P.O. Box 1988 (M-19) Santa Ana, CA 92702 (714) 647-s800 www,santa-ana.org APP-13 CBC 20't6 NOTICE TO PROPERTY OWNER Dear Property Owner: An applicati specified at on for a buildin oerm b'd it has been ubmitted in you l-â‚¬ rna e listin g you f as the builder of the property improvements Qr e-. 5 Ua -tt z o We are providing you with an Owner-Builder Acknowledoment and lnformation Veriflcation Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your names as the Owner-Builder We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agentofthe owner cannot execute this notice unless you, the prope(y owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEGMENT AND VERIFICATION OF INFORMATON DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. ,4 I [\- I t understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" build- ing permit that erroneously implies that the property owner is providing his or her own labor and material personally. l, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my prop- erty. {A\ \-'2. I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. pL 3. I understand as an "Owner-Builder'' I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. -l YVO. ' understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. WU , understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an 'employel' under state and federal law. LU I understand if I am considered an "employef' under state and Federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment com- pensation of each "employee." I also understand my failure to abide by these laws may subject me to serious flnancial risk. \YYr. I understand under California Contractors' State License Law, an owner-Builder who builds single-family residential "-ku"trres cannot legally build them with the intent to offer them for sale, unless a// work is performed by licensed subcontrac- tors and the number of structures does not exceed four within any calendar years, or all of the work is performed under contract with a licensed general building Contractor. r 8. I understand as an Owner-Builder if I sell the property for which this permrt is issued, I may be held liable for any finan- Ei6lii personal injuries sustained by any subsequent owne(sj that result from any latent construction defects in the workman- ship or materials. / (l* ' understand I may obtain more information regarding my ob'ligations as an "employei'from the lnternal Revenue Ser- vice, the United States Small Business Administration, the Califomia Department of Benefit Payments, and the California Divi- sion of lndustrial Accidents. lalso understand lmaycontactthe Califorrria Contractors' State License Board (CSLB) at1-800- 321-CSLB (2752) or www.cslb.ca.oov for more information about licensed contractors. A i \-210. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the following ad- dress: 1. I agree that, as the party legally and flnancially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. (\" I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. lf you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. lt is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. lf you obtain a permit as Owner-Builder and wish to hire Contactors, you will be responsible for verifying whether or not those Contractors are properly li Y Before a building permit can be issued, this\ to the agency responsible for issuing the pe censed and the status of their workers' compensation insurance coverage. form must be completed and signed by the property owner and returned rmit. ,Vote.' A coDv oLthe ploperty owner's driver's license, form notariza- o d when the rmit is issued to the DroDertv ow ner's siqn atu re. Sig nature of Property Owner Date Z t I6 ?tc Print name of Owner B Lea- AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Scope of Construction Project (or Description of Work)ir s+a.il ,'h Iatt"tl dprhLrr^,t. C (oler r l a,le, tr. -e QT ku< S.+'& 4 A 9^^1" Axq d 270 lo l',on 14 ^ Address of Authorized Agent:O D, Ed;â‚¬f ftr.,". 9u-,le* A sa,"+r^ h^cA qL70 Phone Number of Authorized Agent 7t4-) r+>o+t8 I declare under penalty of perjury that I am the property owner r the address listed above and I personally fllled out the above information and certify its accuracy Property Owneis Signature Date 7-[l3 I !_o Print Name of Owner Br.l^".L Lt <, Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is re- quired to be prcsented when the permit is issued to verffy the propefty owner's signature. Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authodze the following person(s) to act as my agent(s) to apply for, srgn, and file the documents necessary to obtain an Owner-Builder Permit for my proJect. Project Location or Addressl Name of Authorized Agent: